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HEPATITIS A
NANDHANA ANIL
SECOND YEAR BSC NURSING
INTRODUCTION
 Hepatitis A is an acute infectious disease caused by Hepatitis A Virus.
 This disease shows nonspecific symptoms such as fever,chills,headache,fatigue,generalised
weakness,aches and pain followed by Anorexia,nausea,vomiting,dark urine and jaundice.
 This disease is benign with complete recovery in several weeks
DEFINITION
 Hepatitis A (formerly known as infectious Hepatitis or epidemic jaundice) is an acute
infectious disease caused by Hepatitis A Virus
STRUCTURE OF HEPATITIS A VIRUS
CAUSES
 Eating food handled by someone with virus who doesn’t throughly wash his
hands after using the toilet
 Drinking contaminated water
 Eating raw shellfish from water polluted with sewage
 Being in close contact with a person who’s infected even if that person has no
signs or symptoms
 Having sex with someone who has the virus
SIGNS AND SYPMTOMS
 Some of the signs and symptoms of Hepatitis A Virus are :-
 Fatigue
 Sudden nausea and vomiting
 Abdominal pain or discmfort especially on the upper right side
beneath your lower ribs(by your liver)
 Clay coloured bowel movements
 Loss of appetite
 Low grade fever
 Dark urine
 Yellowing of skin and whites of your eyes(jaundice)
 Intense itching
EPIDEMIOLOGICAL FACTORS
AGENT FACTORS
•AGENT : The causative agent Hepatitis A Virus is an enterovirus type(72) of picornaviridae family
•RESISTANCE: The virus is fairly resistant to low PH,heat and chemicals. It can survive more than 10
weeks in well water.It can withstand heating to 60°C for one hour and is not affected by chlorine in
chlorination
•RESERVOIR OF INFECTION: The Humans are the RESERVOIR of infection.It can range from
asymptomatic infection to severe ones.Asymptomatic infection is more common in children
•PERIOD OF INFECTIVITY: The risk of transmitting HAV is greatest from 2 weeks before 0 to 1 week
after onset of jaundice.
•INFECTIVE MATERIAL: Mainly man’s faeces,blood,serum and other fluids are infective materials
 HOST FACTORS
 •AGE : Hepatitis A infection is more common in children than in adults However
people in all ages may be infected if susceptible. In young children infections tend
to be mild or subclinical.the clinical severity increases with age
 •SEX : Both sexes are equally susceptible
 •IMMUNITY: Immunity after infection lasts for life
 •ENVIRONMENTAL FACTORS : In India the disease tends to be associated with
periods of heavy rainfall,poor sanitation and overcrowding spreads the infection
CLINICAL SPECTRUM OF HEPATITIS A
INFECTION
 The onset of jaundice is often preceded by gastrointestinal symptoms such as
nausea,vomiting, anorexia and mild fever
 Jaundice may appear within a few days of prodromal period but anicteric hepatitis
is more common
 Hepatitis A resolves completely in 98% of cases but relapse of symptoms are
noted in 3-20% cases.
COMPLICATIONS
 Hepatitis A doesn’t cause long term liver disease and it doesn’t become chronic
 In rare cases,Hepatitis A can cause sudden loss of liver function especially in older
adults or people with chronic liver diseases.
DIAGNOSIS
 Specific lab diagnosis of Hepatitis A can be obtained by :-
 ● Demonstration of HAV particles or Specific viral antigens in the
faeces,bile,blood.HAV is detected in the stool from about 2 weeks prior to onset of
jaundice upto 2 weeks after
 ●Anti HAV appears in IGM fraction during acute phase,peaking about 2 weeks
prior to onset of after elevation of liver enzymes .Anti HAV IGM usually declines to
non detectable level within 3-6 months after onset of disease and persists for
decades.
 Thus detection of IGM Specific Anti HAV in blood of an acutely infected patient
confirms diagnosis of Hepatitis A.
MODE OF TRANSMISSION
 ■ FAECAL ORAL ROUTE
 This is the major route of transmission.It may occur by direct contact or indirectly
by way of contaminated water,food or milk.
 ■PARENTERAL ROUTE
 Hepatitis A is also transmitted by parenteral route that is blood and blood
needles.this may occur during stage of Viraemia(Presence of virus in Blood)
 ■ SEXUAL TRANSMISSION
 As a sexually transmitted infection may occur among homosexual men’s oral–anal
contact.
MANAGEMENT
 Prevention of overcrowding and poor sanitation
 Active immunization with aninactivated virus vaccination
 Immediate protection by Immediate serum globulin if this is given soon after
exposure to virus
NURSING MANAGEMENT
 The patient is usually manged at home unless symptoms are severe
 The nurse assists family in coping with temporary disability and fatigue that are
common in Hepatitis and instructed them to seek additional health care if symptoms
persist or worsen
 Reduce demands on liver while promoting physical well-being
 Prevent complications
 Enhance self-concept ,acceptance of situation
 Provide information about disease process,prognosis, treatment needs
 Meeting basic self care needs
 Recommend small frequent meals
 Instruct patient to abstain from alcohol during acute illness and for 6 months
after recovery
 Advise patient to avoid substances such as medications that may affect function
PREVENTION
 The best way to prevent Hepatitis A is through vaccination with Hepatitis A
vaccine
 • Formaldehyde inactivated vaccines
 •Livs attenuated vaccines
 Human immunoglobulin – The protective efficacy of immune globulin against the
HAV infection is approx 1-2 months and 3-5 months following administration of
IgG at dose of 0.02-0.06ml/kg body weight
 Control of transmission: The best way to reduce disease transmission is simple measures of
personal and community hygiene.Eg Handwasshing before eating and after using
toilet,sanitary disposal of excreta prevents contamination.
CONCLUSION
 Hepatitis A virus is still a major cause of infection and disease in the world and
heterogeneous pockets of susceptible and exposed individuals may co-exist in
rapidly developing societies.Therefore small localised or large outbreaks of HAV
infection will remain a threat in such areas.
 The situation demands that conclusive guidelines be produced for HAV
vaccination in these communities after characterising them appropriately.
Hepatitis A Virus

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Hepatitis A Virus

  • 2. INTRODUCTION  Hepatitis A is an acute infectious disease caused by Hepatitis A Virus.  This disease shows nonspecific symptoms such as fever,chills,headache,fatigue,generalised weakness,aches and pain followed by Anorexia,nausea,vomiting,dark urine and jaundice.  This disease is benign with complete recovery in several weeks
  • 3. DEFINITION  Hepatitis A (formerly known as infectious Hepatitis or epidemic jaundice) is an acute infectious disease caused by Hepatitis A Virus
  • 5. CAUSES  Eating food handled by someone with virus who doesn’t throughly wash his hands after using the toilet  Drinking contaminated water  Eating raw shellfish from water polluted with sewage  Being in close contact with a person who’s infected even if that person has no signs or symptoms  Having sex with someone who has the virus
  • 6. SIGNS AND SYPMTOMS  Some of the signs and symptoms of Hepatitis A Virus are :-  Fatigue  Sudden nausea and vomiting  Abdominal pain or discmfort especially on the upper right side beneath your lower ribs(by your liver)  Clay coloured bowel movements  Loss of appetite  Low grade fever  Dark urine  Yellowing of skin and whites of your eyes(jaundice)  Intense itching
  • 7. EPIDEMIOLOGICAL FACTORS AGENT FACTORS •AGENT : The causative agent Hepatitis A Virus is an enterovirus type(72) of picornaviridae family •RESISTANCE: The virus is fairly resistant to low PH,heat and chemicals. It can survive more than 10 weeks in well water.It can withstand heating to 60°C for one hour and is not affected by chlorine in chlorination •RESERVOIR OF INFECTION: The Humans are the RESERVOIR of infection.It can range from asymptomatic infection to severe ones.Asymptomatic infection is more common in children •PERIOD OF INFECTIVITY: The risk of transmitting HAV is greatest from 2 weeks before 0 to 1 week after onset of jaundice. •INFECTIVE MATERIAL: Mainly man’s faeces,blood,serum and other fluids are infective materials
  • 8.  HOST FACTORS  •AGE : Hepatitis A infection is more common in children than in adults However people in all ages may be infected if susceptible. In young children infections tend to be mild or subclinical.the clinical severity increases with age  •SEX : Both sexes are equally susceptible  •IMMUNITY: Immunity after infection lasts for life  •ENVIRONMENTAL FACTORS : In India the disease tends to be associated with periods of heavy rainfall,poor sanitation and overcrowding spreads the infection
  • 9. CLINICAL SPECTRUM OF HEPATITIS A INFECTION  The onset of jaundice is often preceded by gastrointestinal symptoms such as nausea,vomiting, anorexia and mild fever  Jaundice may appear within a few days of prodromal period but anicteric hepatitis is more common  Hepatitis A resolves completely in 98% of cases but relapse of symptoms are noted in 3-20% cases.
  • 10. COMPLICATIONS  Hepatitis A doesn’t cause long term liver disease and it doesn’t become chronic  In rare cases,Hepatitis A can cause sudden loss of liver function especially in older adults or people with chronic liver diseases.
  • 11. DIAGNOSIS  Specific lab diagnosis of Hepatitis A can be obtained by :-  ● Demonstration of HAV particles or Specific viral antigens in the faeces,bile,blood.HAV is detected in the stool from about 2 weeks prior to onset of jaundice upto 2 weeks after  ●Anti HAV appears in IGM fraction during acute phase,peaking about 2 weeks prior to onset of after elevation of liver enzymes .Anti HAV IGM usually declines to non detectable level within 3-6 months after onset of disease and persists for decades.  Thus detection of IGM Specific Anti HAV in blood of an acutely infected patient confirms diagnosis of Hepatitis A.
  • 12. MODE OF TRANSMISSION  ■ FAECAL ORAL ROUTE  This is the major route of transmission.It may occur by direct contact or indirectly by way of contaminated water,food or milk.  ■PARENTERAL ROUTE  Hepatitis A is also transmitted by parenteral route that is blood and blood needles.this may occur during stage of Viraemia(Presence of virus in Blood)  ■ SEXUAL TRANSMISSION  As a sexually transmitted infection may occur among homosexual men’s oral–anal contact.
  • 13. MANAGEMENT  Prevention of overcrowding and poor sanitation  Active immunization with aninactivated virus vaccination  Immediate protection by Immediate serum globulin if this is given soon after exposure to virus
  • 14. NURSING MANAGEMENT  The patient is usually manged at home unless symptoms are severe  The nurse assists family in coping with temporary disability and fatigue that are common in Hepatitis and instructed them to seek additional health care if symptoms persist or worsen  Reduce demands on liver while promoting physical well-being  Prevent complications  Enhance self-concept ,acceptance of situation  Provide information about disease process,prognosis, treatment needs  Meeting basic self care needs  Recommend small frequent meals
  • 15.  Instruct patient to abstain from alcohol during acute illness and for 6 months after recovery  Advise patient to avoid substances such as medications that may affect function
  • 16. PREVENTION  The best way to prevent Hepatitis A is through vaccination with Hepatitis A vaccine  • Formaldehyde inactivated vaccines  •Livs attenuated vaccines  Human immunoglobulin – The protective efficacy of immune globulin against the HAV infection is approx 1-2 months and 3-5 months following administration of IgG at dose of 0.02-0.06ml/kg body weight
  • 17.  Control of transmission: The best way to reduce disease transmission is simple measures of personal and community hygiene.Eg Handwasshing before eating and after using toilet,sanitary disposal of excreta prevents contamination.
  • 18. CONCLUSION  Hepatitis A virus is still a major cause of infection and disease in the world and heterogeneous pockets of susceptible and exposed individuals may co-exist in rapidly developing societies.Therefore small localised or large outbreaks of HAV infection will remain a threat in such areas.  The situation demands that conclusive guidelines be produced for HAV vaccination in these communities after characterising them appropriately.